Norman is just the unfortunate victim of a blocked urinary tract, which according to my vet is a very common problem in tom cats. In his case, the blockage was so bad that the only cure was a perineal urethrostomy—essentially a kitty sex change. Norman’s still 100% male in his little cat brain; he just doesn’t have male equipment any more.
If there were veterinarians performing real "transsexual" mutilations on animals -- helping with their "gender identities".... now that's just too creepy a thought....